How can someone deal with sexual urges

From: Alzheimer Info 2/17

Sexuality is part of everyone's life, with or without dementia. Sexuality does not only mean sexual acts such as intercourse or masturbation. It's about love, affection, tenderness and trust. Even if people with dementia lose many skills and their personality changes, they remain women and men with different characteristics, with individual life paths and sexual experiences. People with dementia often stand out because they can no longer orientate themselves to the usual social rules. This may also apply to sexual behavior: some people with dementia express their sexual desires very directly, even to people who are not partners.

This behavior is caused by damage to the brain. The brain is the control center for feelings and behavior, and it "produces" sexual fantasies. If the organ is damaged by dementia, the control mechanisms for sexual behavior can fail. This is particularly the case with frontotemporal dementia (FTD). The sick often experience uninhibited and impulsive reactions. Knowledge of social rules (including those relating to sexual intercourse) is lost. FTD sufferers are unaware that their behavior can offend and hurt others.

How dementia affects sexual behavior

People with dementia have difficulty grasping other people's statements at an early stage, especially when they refer to the future. Therefore, the phrase "Time for bed!", Which is said in passing, can be completely misunderstood - namely as a concrete invitation to sex. People with dementia can no longer communicate well and express their feelings. As a result, they either express themselves very directly or find no words at all. That makes it harder to initiate and live sexual contacts.

It can happen that they touch someone who is attractive to them unsolicited and inappropriately. Due to dementia, the orientation in time is lost. A sound, a smell or a picture can trigger a memory. The sick person experiences this inner past as present and then perhaps confuses the young nurse with the wife at a young age. People with dementia find it difficult to find their way around their surroundings. In the inpatient facility, in search of their own bed, they can end up in someone else's room or bed. They lose the ability to differentiate between what is private and what is public. Therefore, it can happen that they satisfy themselves in front of relatives or roommates.

Challenge for relatives and caregivers

Some people with dementia develop an increased interest in sex. Still others lose interest in it in the course of their illness. Both have a great influence on a partnership. The healthy partners then have to deal with the changed behavior. And their own needs may no longer have a place in the relationship. It is often difficult for adult children to continue to imagine their parents as sexually active beings.

Physical care always means contact with very intimate areas of the body. It can therefore happen that people with dementia show their sexual arousal or make explicit offers during personal hygiene. Caring for people with dementia is also often a major challenge for employees in homes, shared apartments and outpatient services. Their sexual behavior can cause irritation and disrupt the usual care routine and everyday life in a facility.

No one with dementia is like another. It is all the more important not to make sexuality taboo. Allegations don't help. If an uncomfortable situation arises, one should react clearly and calmly and be aware that the behavior is mostly due to illness. Knowing what drives the person affected helps to find a solution.

Helga Schneider-Schelte
German Alzheimer's Society

Bibliography:
profamilia: sexuality and dementia. Brochure for relatives and caregivers, available free of charge as a PDF at www.profamilia.de> Publications> for adults

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